1
|
Shavlovskaya OA, Bokova IA. [Asthenic disorders correction with Recognan]. Zh Nevrol Psikhiatr Im S S Korsakova 2024; 124:57-62. [PMID: 38529864 DOI: 10.17116/jnevro202412403157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
Abstract
Asthenia, asthenic syndrome, asthenic condition, asthenic reaction, asthenic disorders are terms that describe the state of «impotence». Fatigue that occurs against the background of habitual physical or intellectual stress for a person, and persists after rest, is asthenia. For people of the older age group, the term senile asthenia syndrome is used. Asthenia manifests itself with increased fatigue and exhaustion, mood instability, increased irritability, sleep disorders. Asthenic conditions manifest themselves along with a decrease in physical activity, increased cognitive and mental fatigue. Asthenic syndrome (AS) are considered as an integral part of cardiovascular diseases (CVD), as one of the manifestations of cerebrovascular pathology. Senile asthenia syndrome (SAS) is a geriatric syndrome characterized by an age-associated decrease in the physiological reserve and functions of many body systems, including cognitive functions. One of the drugs that has a positive effect on the severity of AS and improves the state of cognitive functions is the domestic drug Recognan (citicoline). The effectiveness of Recognan in the treatment of AS in patients with CVD, SAS, and post-COVID asthenia has been shown. It is recommended to prescribe Recognan orally at 500 mg / day for 30 days. Recognan has a nootropic and antiasthenic effect.
Collapse
Affiliation(s)
| | - I A Bokova
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| |
Collapse
|
2
|
Alrashid Alhiraki O, Fahham O, Dubies HA, Abou Hatab J, Ba'Ath ME. Conflict-related excess mortality and disability in Northwest Syria. BMJ Glob Health 2022; 7:bmjgh-2022-008624. [PMID: 35589154 PMCID: PMC9121437 DOI: 10.1136/bmjgh-2022-008624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 05/08/2022] [Indexed: 11/19/2022] Open
Abstract
Introduction The Syrian conflict that started in 2011 has been ongoing for over a decade without an end in sight. Estimates regarding excess mortality and conflict-related disability vary widely, and little field research has been done to address this topic. Methods A population-based field survey was conducted from 10 to 18 November 2020 in Northwest Syria. Forty-nine clusters were selected using staged sampling based on predefined population distribution maps. Data were collected for the period from 2000 to 2020 and were divided into pre-conflict (2000–2010) and conflict (2011–2020) periods. Mortality rates were compared using the Mann-Whitney U test, and p<0.05 was considered statistically significant. Results A total of 1483 households were surveyed, for a population of 12 268 people. The crude mortality rate increased 3.55 times between the two periods (p>0.001). In total, 54.3% of war-related deaths were caused by aerial attacks. Despite the continued increase in mortality rates during the conflict period, most deaths from 2017 onwards were related to non-violent causes. Overall, directly and indirectly, the conflict seems to have caused approximately 874 000 excess deaths. A total of 14.9% of households reported having at least one substantial violence-related disability since 2011. Conclusion The conflict caused the tripling of mortality rates in Syria. The estimated excess mortality in our study is higher than previous estimates. From 2017 onwards, most conflict-related deaths were due to non-violent causes. There is a high prevalence of violence-related disabilities in the studied communities. Our data could prove useful for health policymakers.
Collapse
Affiliation(s)
- Omar Alrashid Alhiraki
- Department of Surgery, Bab Al-Hawa Hospital, Idlib, Northwest Syria, Syrian Arab Republic .,Syria Research Group (SyRG), co-hosted by the London School of Hygiene and Tropical Medicine and Saw Swee Hock School of Public Health, London, UK
| | - Ola Fahham
- Syria Research Group (SyRG), co-hosted by the London School of Hygiene and Tropical Medicine and Saw Swee Hock School of Public Health, London, UK.,Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK
| | - Hussam Alden Dubies
- Department of Surgery, Idlib University, Faculty of Medicine, Idlib, Northwest Syria, Syrian Arab Republic
| | - Jawad Abou Hatab
- Faculty of Medicine, Free Aleppo University, Aleppo, Northwest Syria, Syrian Arab Republic
| | - Muhammad Eyad Ba'Ath
- Department of Surgery, Bab Al-Hawa Hospital, Idlib, Northwest Syria, Syrian Arab Republic
| |
Collapse
|
3
|
Janeway MG, Zhao X, Rosenthaler M, Zuo Y, Balasubramaniyan K, Poulson M, Neufeld M, Siracuse JJ, Takahashi CE, Allee L, Dechert T, Burke PA, Li F, Kalesan B. Clinical diagnostic phenotypes in hospitalizations due to self-inflicted firearm injury. J Affect Disord 2021; 278:172-180. [PMID: 32961413 DOI: 10.1016/j.jad.2020.09.067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Revised: 07/07/2020] [Accepted: 09/11/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND . Hospitalized self-inflicted firearm injuries have not been extensively studied, particularly regarding clinical diagnoses at the index admission. The objective of this study was to discover the diagnostic phenotypes (DPs) or clusters of hospitalized self-inflicted firearm injuries. METHODS . Using Nationwide Inpatient Sample data in the US from 1993 to 2014, we used International Classification of Diseases, Ninth Revision codes to identify self-inflicted firearm injuries among those ≥18 years of age. The 25 most frequent diagnostic codes were used to compute a dissimilarity matrix and the optimal number of clusters. We used hierarchical clustering to identify the main DPs. RESULTS . The overall cohort included 14072 hospitalizations, with self-inflicted firearm injuries occurring mainly in those between 16 to 45 years of age, black, with co-occurring tobacco and alcohol use, and mental illness. Out of the three identified DPs, DP1 was the largest (n=10,110), and included most common diagnoses similar to overall cohort, including major depressive disorders (27.7%), hypertension (16.8%), acute post hemorrhagic anemia (16.7%), tobacco (15.7%) and alcohol use (12.6%). DP2 (n=3,725) was not characterized by any of the top 25 ICD-9 diagnoses codes, and included children and peripartum women. DP3, the smallest phenotype (n=237), had high prevalence of depression similar to DP1, and defined by fewer fatal injuries of chest and abdomen. LIMITATIONS . Claims data. CONCLUSIONS . There were three distinct diagnostic phenotypes in hospitalizations due to self-inflicted firearm injuries. Further research is needed to determine how DPs can be used to tailor clinical care and prevention efforts.
Collapse
Affiliation(s)
- Megan G Janeway
- Department of Surgery, Boston University Medical Center, Boston, MA, USA
| | - Xiang Zhao
- Department of Medicine and Mathematics and Statistics, Boston University School of Medicine and Graduate School of Arts and Sciences, Boston, MA, USA
| | - Max Rosenthaler
- Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Yi Zuo
- Department of Biostatistics, Vanderbilt University School of Medicine, Nashville, TN, USA
| | | | - Michael Poulson
- Department of Surgery, Boston University Medical Center, Boston, MA, USA
| | - Miriam Neufeld
- Department of Surgery, Boston University Medical Center, Boston, MA, USA
| | - Jeffrey J Siracuse
- Department of Surgery, Boston University Medical Center, Boston, MA, USA
| | | | - Lisa Allee
- Department of Surgery, Boston University Medical Center, Boston, MA, USA
| | - Tracey Dechert
- Department of Surgery, Boston University Medical Center, Boston, MA, USA
| | - Peter A Burke
- Department of Surgery, Boston University Medical Center, Boston, MA, USA
| | - Feng Li
- School of Statistics and Mathematics, Central University of Finance and Economics, Beijing, China
| | - Bindu Kalesan
- Department of Medicine and Community Health Sciences, Boston University, 72 E Concord St L-516, Boston, MA 02118, USA.
| |
Collapse
|
4
|
Bose D, Mondal A, Saha P, Kimono D, Sarkar S, Seth RK, Janulewicz P, Sullivan K, Horner R, Klimas N, Nagarkatti M, Nagarkatti P, Chatterjee S. TLR Antagonism by Sparstolonin B Alters Microbial Signature and Modulates Gastrointestinal and Neuronal Inflammation in Gulf War Illness Preclinical Model. Brain Sci 2020; 10:brainsci10080532. [PMID: 32784362 PMCID: PMC7463890 DOI: 10.3390/brainsci10080532] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 07/28/2020] [Accepted: 08/05/2020] [Indexed: 02/07/2023] Open
Abstract
The 1991 Persian Gulf War veterans presented a myriad of symptoms that ranged from chronic pain, fatigue, gastrointestinal disturbances, and cognitive deficits. Currently, no therapeutic regimen exists to treat the plethora of chronic symptoms though newer pharmacological targets such as microbiome have been identified recently. Toll-like receptor 4 (TLR4) antagonism in systemic inflammatory diseases have been tried before with limited success, but strategies with broad-spectrum TLR4 antagonists and their ability to modulate the host-microbiome have been elusive. Using a mouse model of Gulf War Illness, we show that a nutraceutical, derived from a Chinese herb Sparstolonin B (SsnB) presented a unique microbiome signature with an increased abundance of butyrogenic bacteria. SsnB administration restored a normal tight junction protein profile with an increase in Occludin and a parallel decrease in Claudin 2 and inflammatory mediators high mobility group box 1 (HMGB1), interleukin-1β (IL-1β), and interleukin-6 (IL-6) in the distal intestine. SsnB also decreased neuronal inflammation by decreasing IL-1β and HMGB1, while increasing brain-derived neurotrophic factor (BDNF), with a parallel decrease in astrocyte activation in vitro. Mechanistically, SsnB inhibited the binding of HMGB1 and myeloid differentiation primary response protein (MyD88) to TLR4 in the intestine, thus attenuating TLR4 downstream signaling. Studies also showed that SsnB was effective in suppressing TLR4-induced nod-like receptor protein 3 (NLRP3) inflammasome activation, a prominent inflammatory disease pathway. SsnB significantly decreased astrocyte activation by decreasing colocalization of glial fibrillary acid protein (GFAP) and S100 calcium-binding protein B (S100B), a crucial event in neuronal inflammation. Inactivation of SsnB by treating the parent molecule by acetate reversed the deactivation of NLRP3 inflammasome and astrocytes in vitro, suggesting that SsnB molecular motifs may be responsible for its anti-inflammatory activity.
Collapse
Affiliation(s)
- Dipro Bose
- Environmental Health and Disease Laboratory, Department of Environmental Health Sciences, University of South Carolina, Columbia, SC 29208, USA; (D.B.); (A.M.); (P.S.); (D.K.); (S.S.); (R.K.S.)
| | - Ayan Mondal
- Environmental Health and Disease Laboratory, Department of Environmental Health Sciences, University of South Carolina, Columbia, SC 29208, USA; (D.B.); (A.M.); (P.S.); (D.K.); (S.S.); (R.K.S.)
| | - Punnag Saha
- Environmental Health and Disease Laboratory, Department of Environmental Health Sciences, University of South Carolina, Columbia, SC 29208, USA; (D.B.); (A.M.); (P.S.); (D.K.); (S.S.); (R.K.S.)
| | - Diana Kimono
- Environmental Health and Disease Laboratory, Department of Environmental Health Sciences, University of South Carolina, Columbia, SC 29208, USA; (D.B.); (A.M.); (P.S.); (D.K.); (S.S.); (R.K.S.)
| | - Sutapa Sarkar
- Environmental Health and Disease Laboratory, Department of Environmental Health Sciences, University of South Carolina, Columbia, SC 29208, USA; (D.B.); (A.M.); (P.S.); (D.K.); (S.S.); (R.K.S.)
| | - Ratanesh K. Seth
- Environmental Health and Disease Laboratory, Department of Environmental Health Sciences, University of South Carolina, Columbia, SC 29208, USA; (D.B.); (A.M.); (P.S.); (D.K.); (S.S.); (R.K.S.)
| | - Patricia Janulewicz
- Department of Environmental Health, Boston University School of Public Health, Boston, MA 02118, USA; (P.J.); (K.S.)
| | - Kimberly Sullivan
- Department of Environmental Health, Boston University School of Public Health, Boston, MA 02118, USA; (P.J.); (K.S.)
| | - Ronnie Horner
- Department of Health Services Policy and Management, University of South Carolina, Columbia, SC 29208, USA;
| | - Nancy Klimas
- Department of Clinical Immunology, Nova Southeastern University, Fort Lauderdale, FL 33314, USA;
- Miami VA Medical Center, Miami, FL 33125, USA
| | - Mitzi Nagarkatti
- Department of Pathology Microbiology and Immunology, USC School of Medicine, Columbia, SC 29209, USA; (M.N.); (P.N.)
| | - Prakash Nagarkatti
- Department of Pathology Microbiology and Immunology, USC School of Medicine, Columbia, SC 29209, USA; (M.N.); (P.N.)
| | - Saurabh Chatterjee
- Environmental Health and Disease Laboratory, Department of Environmental Health Sciences, University of South Carolina, Columbia, SC 29208, USA; (D.B.); (A.M.); (P.S.); (D.K.); (S.S.); (R.K.S.)
- Columbia VA Medical Center, Columbia, SC 29209, USA
- Correspondence: ; Tel.: +1-803-777-8120; Fax: +1-803-777-3391
| |
Collapse
|
5
|
Bjørklund G, Pivina L, Dadar M, Semenova Y, Rahman MM, Chirumbolo S, Aaseth J. Depleted uranium and Gulf War Illness: Updates and comments on possible mechanisms behind the syndrome. ENVIRONMENTAL RESEARCH 2020; 181:108927. [PMID: 31796256 DOI: 10.1016/j.envres.2019.108927] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 11/13/2019] [Accepted: 11/14/2019] [Indexed: 06/10/2023]
Abstract
Indications of proximal tubule effects have been observed in recent surveillance study of Gulf War veterans exposed to depleted uranium (DU). This gives some support for the suspicion that DU may represent one of the causes for the so-called Persian Gulf syndrome. Proposed effects may be especially harmful if the toxicity hits the mitochondrial DNA since the mitochondria lack the nucleotide excision repair mechanism, which is needed for repairing bulky adducts that have been associated with DU. It is a plausible working hypothesis that a significant part of the symptoms from various organs, which have been observed among veterans from Gulf War 1 and that have been grouped under the name of the Persian Gulf syndrome, may be explained as a consequence of mitochondrial DNA damage in various cell types and organs. Interpretation of observations, on military personnel and civilians after Gulf War 1, is associated with difficulties because of the abundance of potential confounding factors. The symptoms observed on veterans from Gulf War 1 may be attributed to a multiplicity of substances functioning directly or indirectly as mitochondrial mutagens. A concise analysis of the cascade of toxic effects initiated by DU exposure in the human body is the subject of this article.
Collapse
Affiliation(s)
- Geir Bjørklund
- Council for Nutritional and Environmental Medicine (CONEM), Mo i Rana, Norway.
| | - Lyudmila Pivina
- Semey Medical University, Semey, Kazakhstan; CONEM Kazakhstan Environmental Health and Safety Research Group, Semey Medical University, Semey, Kazakhstan
| | - Maryam Dadar
- Razi Vaccine and Serum Research Institute, Agricultural Research, Education and Extension Organization (AREEO), Karaj, Iran
| | - Yuliya Semenova
- Semey Medical University, Semey, Kazakhstan; CONEM Kazakhstan Environmental Health and Safety Research Group, Semey Medical University, Semey, Kazakhstan
| | - Md Mostafizur Rahman
- Department of Environmental Sciences, Jahangirnagar University, Dhaka, Bangladesh
| | - Salvatore Chirumbolo
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy; CONEM Scientific Secretary, Verona, Italy
| | - Jan Aaseth
- Research Department, Innlandet Hospital Trust, Brumunddal, Norway; IM Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| |
Collapse
|
6
|
Rafehivola IH, Raharivelo A, Rakotomavo F, Andriambao DS. [A manner of voicing, the mass hysteria]. Encephale 2015; 41:556-9. [PMID: 26603972 DOI: 10.1016/j.encep.2014.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Accepted: 08/04/2014] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Mass hysteria is defined as the epidemic occurrence of a succession of physical symptoms without organic disorder or identifiable illness agents. The hysteria epidemic has been described since the Middle Ages, reported in different cultures and religions and affects different populations throughout the world. Few studies on the subject have been under takenin Madagascar. We aim at describing in this study the clinical and therapeutic aspects of a mass hysteria that has occurred in the South of Madagascar. METHODOLOGY The study is retrospective and prospective at the same time. It concerns the victims of a mass hysteria that had occurred in a village (Ikalahazo) in the South of Madagascar,from the 6th of April 2009 to the 7th of May 2009. Patients exhibiting clinical symptoms ofconversive behavior and having undergone an assessment in hospital surroundings represent the object of this study. During the study period, 27 cases of young women were reported, 22 ofthem were sent to the University Hospital Center of Fianarantsoa (UHCF), a referring center o fthe region, for a thorough clinical examination. Demographic data, the clinical aspects and thecare and treatment provided are the studied parameters. RESULT During a land ownership dissension that drags on endlessly in Ikalahazo village, exclusively 27 young women, between 8 and 21 years old, presented atypical symptoms, strangedisorders. A first case appeared on the 6th of April 2009, that is to say a month before alarge manifestation of the crisis. A similar case was observed two years ago, but it was an isolated case. The symptoms, primarily with motive manifestation, extended rapidly but remainedhowever limited, susceptible to the "Mpiandry" (literally "shepherds") advice. As the villagers believed that spiteful spirits were at the origin of the deeds, they appealed to the latter. Facing the symptoms persistence, the Neuropsychiatry Unit employees of the CHUF were sent to the village on the 6th of May 2009. The intense adhesion of villagers to a belief in satanic misdeedscomplicated their somatic assessment, the results of which showed no distinctive features. At the end of the land dissension proceedings that was resolved in favor of the villagers, and after the isolation of the "madwomen" in the Mpiandry’s camp, no more pathological cases related to the above occurrence were reported. CONCLUSION A mass hysteria diagnosis is retained. It is favored and kept up by local dissensions,by the villagers' belief and its large media casting, thanks to the shepherds' presence. It mingles culture, tradition and modern psychiatry. Therefore, care and treatment of the disorder to be appropriate and optimal require the cooperation between these three spheres.
Collapse
|
7
|
De la subjectivité sociétale d’un déni de la subjectivité individuelle à la perception subjective des diagnostics en pratique clinique : la possibilité partielle d’un diagnostic standardisé de cette perception. EVOLUTION PSYCHIATRIQUE 2015. [DOI: 10.1016/j.evopsy.2014.05.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
|
8
|
|